Add-on effectiveness of methotrexate or iguratimod in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors: The ANSWER cohort study

Ebina, Kosuke; Hirano, Toru; Maeda, Yuichi; Okita, Yasutaka; Etani, Yuki; Hirao, Makoto; Yamamoto, Wataru; Hashimoto, Motomu; Murata, Koichi; Onishi, Akira; Jinno, Sadao; Hara, Ryota; Son, Yonsu; Amuro, Hideki; Kotani, Takuya; Shiba, Hideyuki; Katayama, Masaki; Yamamoto, Keiichi; Kumanogoh, Atsushi; Okada, Seiji; Nakata, Ken

doi:https://doi.org/10.1093/mr/roac092

Add-on effectiveness of methotrexate or iguratimod in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors: The ANSWER cohort study

Ebina, Kosuke; Hirano, Toru; Maeda, Yuichi et al.

Modern Rheumatology, 2023, 33(4), 690-699

Number of Access:2,554（2025-07-24 02:11 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/93986

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Title	Add-on effectiveness of methotrexate or iguratimod in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors: The ANSWER cohort study
Creator	NRID 1000070612076 1000070612076 researchmap permalink k-ebina k-ebina Scopus Author ID 8415453300 8415453300 ORCID 0000-0002-2426-1024 0000-0002-2426-1024 CreatorName Ebina, Kosuke
	CreatorName Hirano, Toru
	NRID 1000010815658 1000010815658 researchmap permalink yuichimeada yuichimeada CreatorName Maeda, Yuichi
	researchmap permalink y_okita y_okita Scopus Author ID 57206222555 57206222555 CreatorName Okita, Yasutaka
	NRID 1000060898930 1000060898930 ORCID 0000-0001-5741-5969 0000-0001-5741-5969 researchmap permalink Yetani0302 Yetani0302 CreatorName Etani, Yuki
	NRID 1000010527708 1000010527708 CreatorName Hirao, Makoto
	CreatorName Yamamoto, Wataru
	NRID 1000060512845 1000060512845 CreatorName Hashimoto, Motomu
	NRID 1000060806793 1000060806793 CreatorName Murata, Koichi
	NRID 1000060634269 1000060634269 CreatorName Onishi, Akira
	CreatorName Jinno, Sadao
	NRID 1000010597107 1000010597107 CreatorName Hara, Ryota
	CreatorName Son, Yonsu
	CreatorName Amuro, Hideki
	NRID 1000080411362 1000080411362 CreatorName Kotani, Takuya
	CreatorName Shiba, Hideyuki
	CreatorName Katayama, Masaki
	CreatorName Yamamoto, Keiichi
	NRID 1000010294125 1000010294125 researchmap permalink read0051725 read0051725 Scopus Author ID 6602726311 6602726311 ORCID 0000-0003-4749-7117 0000-0003-4749-7117 CreatorName Kumanogoh, Atsushi
	NRID 1000030448435 1000030448435 ORCID 0000-0002-5107-8209 0000-0002-5107-8209 researchmap permalink okadaseiji okadaseiji Scopus Author ID 35079139100 35079139100 CreatorName Okada, Seiji
	NRID 1000000283747 1000000283747 researchmap permalink ken-nakata ken-nakata Scopus Author ID 7402151308 7402151308 CreatorName Nakata, Ken
Subject	Iguratimod
	inadequate response
	Janus kinase inhibitor
	methotrexate
	rheumatoid arthritis
Description	This is a pre-copyedited, author-produced version of an article accepted for publication in Modern Rheumatology following peer review. The version of record, Ebina K., Hirano T., Maeda Y., et al. Add-on effectiveness of methotrexate or iguratimod in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors: The ANSWER cohort study. Modern Rheumatology 33, 690 (2023) is available online at: https://academic.oup.com/mr/article-abstract/33/4/690/6664276?redirectedFrom=fulltext and https://doi.org/10.1093/mr/roac092
Abstract	Objectives: This multicenter, retrospective study evaluated the effectiveness of add-on methotrexate (MTX) or iguratimod (IGU) in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors (JAKis). Methods: Forty-five patients were treated with new additional MTX (n = 22) or IGU (n = 23) and followed for 6 months. Patients' background is as follows: age, 59.2 years; disease activity score of 28 joints with C-reactive protein (DAS28-CRP), 3.4; clinical disease activity index, 15.7; biological disease-modifying antirheumatic drug (DMARD)-switched cases, 77.8%; first JAKi cases, 95.6%; and JAKi treatment: tofacitinib (n = 25), baricitinib (n = 17), upadacitinib (n = 2), and peficitinib (n = 1) for 9.6 months. Results: Thirty-five patients continued the combination therapy for 6 months without a significant change in concomitant glucocorticoid or other conventional synthetic DMARDs. DAS28-CRP (MTX, 3.6 to 2.6, p < 0.05; IGU, 3.3 to 2.1, p < 0.001) and clinical disease activity index (MTX, 16.7 to 8.8, p < 0.05; IGU, 14.6 to 6.5, p < 0.01) improved significantly from baseline. Using the 2019 European League Against Rheumatism criteria, 45.4% (MTX) and 39.1% (IGU) achieved moderate or good response and 40.9% (MTX) and 39.1% (IGU) achieved American College of Rheumatology 20% improvement criteria. Conclusions: Adding MTX or IGU to inadequate responders of JAKi can be considered as a complementary treatment.
Publisher	Oxford University Press
Source Title	Modern Rheumatology
Volume (Issue)	33(4)
Page	690-699
Date of Issued	2023-07-01
Language	English
Handle URL	https://hdl.handle.net/11094/93986
PISSN	14397595
eISSN	14397609
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1093/mr/roac092
Access Rights	open access
CopyRight	© 2022 Japan College of Rheumatology. Published by Oxford University Press. All rights reserved.
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Modern Rheumatology. 2023, 33(4), p. 690-699
DC.title	Add-on effectiveness of methotrexate or iguratimod in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors: The ANSWER cohort study
DC.creator	Ebina, Kosuke
	Hirano, Toru
	Maeda, Yuichi
	Okita, Yasutaka
	Etani, Yuki
	Hirao, Makoto
	Yamamoto, Wataru
	Hashimoto, Motomu
	Murata, Koichi
	Onishi, Akira
	Jinno, Sadao
	Hara, Ryota
	Son, Yonsu
	Amuro, Hideki
	Kotani, Takuya
	Shiba, Hideyuki
	Katayama, Masaki
	Yamamoto, Keiichi
	Kumanogoh, Atsushi
	Okada, Seiji
	Nakata, Ken
DC.publisher	Oxford University Press
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2023-07-01
DC.identifier	https://doi.org/10.1093/mr/roac092
DC.subject	Iguratimod
	inadequate response
	Janus kinase inhibitor
	methotrexate
	rheumatoid arthritis
DC.description	This is a pre-copyedited, author-produced version of an article accepted for publication in Modern Rheumatology following peer review. The version of record, Ebina K., Hirano T., Maeda Y., et al. Add-on effectiveness of methotrexate or iguratimod in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors: The ANSWER cohort study. Modern Rheumatology 33, 690 (2023) is available online at: https://academic.oup.com/mr/article-abstract/33/4/690/6664276?redirectedFrom=fulltext and https://doi.org/10.1093/mr/roac092
DCTERMS.abstract	Objectives: This multicenter, retrospective study evaluated the effectiveness of add-on methotrexate (MTX) or iguratimod (IGU) in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors (JAKis). Methods: Forty-five patients were treated with new additional MTX (n = 22) or IGU (n = 23) and followed for 6 months. Patients' background is as follows: age, 59.2 years; disease activity score of 28 joints with C-reactive protein (DAS28-CRP), 3.4; clinical disease activity index, 15.7; biological disease-modifying antirheumatic drug (DMARD)-switched cases, 77.8%; first JAKi cases, 95.6%; and JAKi treatment: tofacitinib (n = 25), baricitinib (n = 17), upadacitinib (n = 2), and peficitinib (n = 1) for 9.6 months. Results: Thirty-five patients continued the combination therapy for 6 months without a significant change in concomitant glucocorticoid or other conventional synthetic DMARDs. DAS28-CRP (MTX, 3.6 to 2.6, p < 0.05; IGU, 3.3 to 2.1, p < 0.001) and clinical disease activity index (MTX, 16.7 to 8.8, p < 0.05; IGU, 14.6 to 6.5, p < 0.01) improved significantly from baseline. Using the 2019 European League Against Rheumatism criteria, 45.4% (MTX) and 39.1% (IGU) achieved moderate or good response and 40.9% (MTX) and 39.1% (IGU) achieved American College of Rheumatology 20% improvement criteria. Conclusions: Adding MTX or IGU to inadequate responders of JAKi can be considered as a complementary treatment.
DC.rights	© 2022 Japan College of Rheumatology. Published by Oxford University Press. All rights reserved.
DC.format	93986
citation_title	Add-on effectiveness of methotrexate or iguratimod in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors: The ANSWER cohort study
citation_author	Ebina, Kosuke
	Hirano, Toru
	Maeda, Yuichi
	Okita, Yasutaka
	Etani, Yuki
	Hirao, Makoto
	Yamamoto, Wataru
	Hashimoto, Motomu
	Murata, Koichi
	Onishi, Akira
	Jinno, Sadao
	Hara, Ryota
	Son, Yonsu
	Amuro, Hideki
	Kotani, Takuya
	Shiba, Hideyuki
	Katayama, Masaki
	Yamamoto, Keiichi
	Kumanogoh, Atsushi
	Okada, Seiji
	Nakata, Ken
citation_publisher	Oxford University Press
citation_language	English
citation_date	2023-07-01
citation_journal_title	Modern Rheumatology
citation_volume	33
citation_issue	4
citation_firstpage	690
citation_lastpage	699
citation_doi	https://doi.org/10.1093/mr/roac092
citation_public_url	https://hdl.handle.net/11094/93986

Add-on effectiveness of methotrexate or iguratimod in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors: The ANSWER cohort study

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